Sensory dysfunction in HTLV-I-associated myelopathy/tropical spastic paraparesis

Castillo J.L.; Cea J G; Verdugo R.J.; Cartier, L

Keywords: temperature, system, conduction, cell, pathways, disease, virus, humans, leukemia, dysfunction, human, male, electromyography, cord, aged, nerve, skin, adult, female, nociception, paraplegia, article, spinal, vibration, sense, afferent, clinical, sensory, tibia, 1, neurologic, response, neurophysiology, priority, middle, journal, examination, Nervous, t, evoked, central, spastic, Paraparesis,, Tropical, somatosensory, myelinated, hypesthesia, paresthesia, Tibial


We performed a comprehensive clinical and neurophysiological evaluation of function of the large- and small-caliber afferent pathways in 29 patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Sensory symptoms, particularly cutaneous paresthesias, were present in 11 (37.9%) patients. On examination, a mild distal impairment of vibration and sense of position were found in 14 (48.2%) and 5 (17.2%) patients, respectively. Ten (34.4%) patients had distal tactile hypoesthesia and 7 (24.1%) presented pinprick hypoesthesia. Quantitative somatosensory thermotest showed cold hypoesthesia in 58.6% of patients. Nerve conduction studies and electromyography were normal. Tibial somatosensory evoked potentials were abnormal in 88.5% of patients. All of the sensory abnormalities found were restricted to sensations carried by myelinated (A-beta and A-delta) fibers. Unmyelinated C fibers mediating warm sensation and thermal pain appeared unimpaired. Our findings indicate that the sensory dysfunction in HAM/TSP patients is probably due to a lesion restricted to the central nervous system.

Más información

Título de la Revista: EUROPEAN NEUROLOGY
Volumen: 42
Número: 1
Editorial: Karger
Fecha de publicación: 1999
Página de inicio: 17
Página final: 22